Step two is intended to support your action planning based on the outputs of step one (the diagnostic tool). It is an opportunity to blend the learning and prompts from the early sections of the resource with your local situation to create a forward plan that is actionable, relevant and compelling for the next stage of your journey.
You should now have a good understanding of your current local care technology offer including areas for further development which have been prioritised.
Step two comprises a series of tips, prompts and questions to support your planning phase. You may want to jump to the areas of priority for you or go through the whole planning guide - use it in a way that best suits your local context.
This resource has the following structure:
- Effective planning - general tips
Does your delivery plan have:
- Clear overarching goals aligned to strategy: organisational and service
- A focus on outputs and outcomes and is clear on inputs and resources required
- Clear actions or activities with timescales and responsibility for delivery
- Interdependencies between tasks and activities understood and visible
- KPIs or equivalent metrics so that you know if you are on track and the actions undertaken are achieving your ends
- Clear governance and accountability:
- Where and when is the plan scrutinised?
- How will you be held to account for delivery?
- Where can you escalate issues and blocks?
- Where, when and how will you review and update the plan in response to emerging issues and learning? E.g. risk log, change control mechanism
- Do you have a clear sponsor for the work?
- A resource plan which clearly articulates the capacity and capability needed for delivery
- A clear underpinning communications and engagement strategy as part of the plan:
- Who needs to know about this work internally and externally?
- Why (decision maker, influencer, affected by the programme, partner)?
- How often?
- What is the right channel or mechanism for each audience?
- Meaningful co-production:
- How can the people affected be involved in the process (staff, service users, partners) so that they own the outputs and can shape the programme so that it meets their needs?
- At what stages and how is it best to achieve this?
Depending on your outputs from step one, the issues that you now want to focus on may be clear. If they're not, consider prioritising what you need to you to achieve your ambitions.
The below prompts might assist:
- What is achievable within the timescales and resources available?
- Where does energy and momentum for the work ahead currently lie?
- Who is engaged and enthused?
- Where are the barriers for change relatively low?
- Are there any areas where focused early work would have a relatively big impact, gaining momentum and demonstrating success?
- Are there foundation activities that need to happen first in order to support activities later in the plan? These might include governance, reviewing contracts or SLAs, securing data on current services and activities to inform longer term planning.
- Are there any elements of the programme that would be difficult or impossible to change? Recognise these, understand the implications, and factor them in
- Consider interdependencies, fit and alignment with other corporate programmes and priorities.
Changing the context
- Do you want to make the case for further resources?
- Would a short options appraisal or feasibility study help leaders make a decision about the payoff between resources and impact and benefits?
- Setting a team
Whatever the scale of your next phase, it is worth considering whether you have the right people and skills engaged in the work to deliver your plan. Consider your resources in the below areas:
- Social care: operations, commissioners, practice leads, occupational therapy and social professional leads
- Finance and performance
- Data and analytics
- Commercial or procurement
- Information governance
- Project management
- Communications, engagement and co-production
- Current care technology service providers
- Other corporate functions e.g. customer service, IT
- Service users and families.
- Setting the parameters and context
What is your operating model for a care technology service going to look like? Consider if there are any policy or political parameters that apply eg. does your council have a pro-in-house provision or pro-commissioned services stance?
Across the sector there are a range of operating models and approaches including:
- A complete end to end managed service that is externally commissioned
- An in-house service. This may include contracts with a range of technology providers or elements of the service (e.g. responder service) that are commissioned externally
- A hybrid model with some elements in-house and some elements commissioned e.g. care alarm, monitoring and response commissioned, wider assistive technology offer in-house, outsourced responder service.
Other points it might be helpful to consider:
- Is your way forward one of incremental improvement to an existing service model or larger transformational change?
- Are there immediate improvements you want to pursue in parallel with a longer-term ambition for a new service?
- Do you have existing service providers who you want to work with to deliver your ambition?
- How are they currently performing and what is their track record of delivery and innovation?
- Can you assess their capability to deliver your new model objectively?
Many councils may have a network of existing community care alarm or telecare providers in place. Consider the politics as well as the practicalities of disrupting these arrangements with new service provider(s), potential TUPE implications of a procurement and the potential knock-on impacts to other local services alongside the potential benefits of a new service provider.
- How dependent are existing local providers on your income or are they diversified across other services or income like self-funders?
- If your plan is likely to include market testing and procurement of any scale consider engaging early with commercial colleagues and start to map out theoretical timelines as part of this planning process
- Consider fit with other services e.g. community equipment service, wider responder service (responding to care alarm alerts for your service, but also meeting other system needs e.g. supported housing)
- Is your service going to focus solely on adult social care or will this be an all age service meeting the needs of your children’s service also?
- What is your ambition for the technology offer in the service?
- How important is generating additional value through analysis and application of data going to be – and at what stage? How digital is the offer in your current service?
- Do you want to focus on achieving financial benefits from reviewing people currently in receipt of care or using care technology for prevention? Or do you want to use it in a more targeted way for existing service users and services? Will there be a focus on supported living or other services pathways (eg reablement, discharge, admission avoidance)?
- Consider your local demography and population profile. This will have many implications for your forward programme, but fundamentally it will drive whether you are likely to stimulate self-funders or whether the service needs to be led and paid for by the council
- Are you considering developing small scale pilots or test and learns as part of your next phase?
Pilots can have a number of benefits including generating local evidence of impact, understanding the implications for staff, systems and processes and increasing knowledge of the technology, the market and the process of change. Equally, a number of councils find that it can be challenging to move out of a test and learn phase, that evaluation of local pilots is not always strong, that they are unable to scale the work from this starting point. Think about your local context and choose an approach which fits.
- Strategy and commissioning
Developing a care technology strategy
Developing a care technology strategy is a fundamental building block if you are on a transformation journey for the service. A good care technology strategy should include all the hallmarks of any good strategy: a clear vision, an understanding of the starting point, clarity on the forward programme, what this will mean for people, staff and other key stakeholders, clear and measurable objectives, resource requirements and data on current services and need. The content will depend on the timeframe of the strategy and the balance between a long-term vision and a clear delivery plan. If you are asking for investment then you may need to produce a business case in line with your own governance processes. Consider how you keep key stakeholders on board (see section 3 – building a team).
Being able to see a clear link between a care technology strategy and the wider corporate strategy could help to secure the support of key influencers and leaders across the wider organisation. Consider how you can provide your lead member and lead officer with the right stories, information, and plans to allow them to champion this work in corporate strategic discussions.
In addition, there is data within the council that you may want to use to plan a future service such as:
- Take-up and type of technology used by your current service users; current penetration by key cohorts / geographies
- Potential need over the longer term
- Use of technology for prevention eg with carers.
A good understanding and local evidence of both financial benefits realisation and impact on outcomes will be important to make the case for the use and potential investment into the service. There is not a standard approach being used across the sector but it is important to understand the type of savings you want to track and how you want to do it.
There are generally four baskets of financial benefits and agreeing which you want to prioritise will be a local decision:
- Genuine cashable savings (such as reducing an existing care package through the installation of technology)
- Efficiency savings (a more streamlined care technology service may reduce admin time for social care staff)
- Cost avoidance (installing technology with a service user which then reduces the care package that they might have had or delays an escalation in care needs)
- Prevention (longer-term financial benefits achieved from keeping a service user or carer living independently for longer)
In many councils, approaches to tracking outcomes are led by the social work professional making the referral and identifying priority outcomes as part of this process which are coproduced with the individual and family. Drawing a direct line between care technology and these outcomes can be tricky – as can the data collection processes that pull this data out and connect it to the care technology service performance framework. Some councils have undertaken its own sample based surveys of care technology customers on a routine basis to get more relevant data about service quality and impact on outcomes.
Policy and charging
Your approach to charging for some or all elements of your technology offer will need agreeing. This may be dictated by existing policies operating in social care. There are a range of approaches being used by councils – some charge for everything, for others everything is free. There are also a full range of approaches in between including subsidy for telecare to promote take-up, free up to a cap and then chargeable.
Try to get data to help understand the impact of your current charging policy if you have one, and speak to staff and providers to see what their experience is. In setting your charging and eligibility policy you might want to consider:
- What are you trying to achieve strategically
- Scale take-up and penetration of all citizens, or of eligible service users?
- Using care technology preventatively before people may have eligible need or with carers?
- A more targeted approach with existing service users with existing care needs?
- What is your local demography? Consider whether it’s likely that people will self-fund or already be eligible.
- How would this policy promote or inhibit take-up in services like reablement and discharge? How would it fit with NHS partners?
- Is there an existing corporate policy which you need to abide by?
- Leadership and resourcing
Establishing effective governance, securing resources and ensuring that you have leaders and champions for your work at different levels in the organisation are all important to establish at the outset.
For governance, consider what existing groups and mechanisms you need to connect to regularly. Is there an appetite for a discrete group on this topic or are you better to link it elsewhere?
Formal leadership (programme sponsor, elected member leadership) can be easily identified but you may need to provide information and intelligence to provide messages, insight and purposeful enthusiasm to influence other senior leaders. Identifying the enthusiasts within adult social care – commissioners, operational staff and professionals – is a good place to start. Think about how you can connect these people into your work even if they are not part of a formal project delivery structure.
- Governance and risk
Discuss issues around information governance and privacy, legal and procurement frameworks need early on. Engage with colleagues in this area from the outset and involve them throughout so any issues can be quickly resolved.
Some key issues experienced by other councils which you may wish to give some forethought to include:
- GDPR and information governance. Concerns about privacy, ownership of data, the reliability and privacy of some of the technology itself, consent.
- Commercial and procurement. Is your standard contract and procurement process fit for purpose, particularly if you are looking to bring in innovative technology and relatively new market entrants?
- Consider financial tests, liability clauses, insurance requirements, evaluation frameworks (cost:quality balance).
- Consider ahead of time issues like TUPE and pensions if you are planning a large-scale procurement
- Legal. Ensure that your legal team are sighted on and have given any relevant advice on your plans early on
- Risk. Consider the general risk appetite in your organisation. Are there any specific risk issues that you might want to consider such as
- What is the response will be if any equipment fails?
- Do you have a risk management / back-up plan in place?
- What are the real risks and implications for service users?
- How does that compare to the arrangements in place now?
There may be a case to be made over time that care technology can help to mitigate risk for service users and that care technology has a contribution to make to issues such as safeguarding.
- Commercial and supplier management
Establishing baseline data is a key starting point here. It may be that you already have good data on current services available to you, or this might be an early foundation activity in your local plan. Consider data on:
- Service volumes. How many, what technology, length of deployment? For incumbents you may also want to understand their mix of self-funders and social care funded users
- Referrals and conversion rates. Source of referrals, types of client referred
- Service quality and standards. Information about service standards such as referral to assessment to install:
- What is the standard and how is current practice?
- Is it improving, stable or deteriorating?
- Are the current service standards a good fit for your service needs (e.g. reablement and discharge may require a 24 hour service)
- Consider customer satisfaction, complaints and compliments, social care staff experience of the service.
Consider the skills and capabilities of your current service and what you might ned to put in place to support improvements if needed (such as staff training). You may also wish to consider bringing in additional capacity and capability through new roles or external support.
Consider what key partners you want to know about, influence or actively participate in the development and delivery of your service. This might include:
- NHS partners. Consider community, mental health and hospital partners as well as commissioners. Is there a local digital forum in your STP/ICS that you can link into?
- Other councils. Districts and boroughs, neighbouring councils, unitaries
- Housing. Social housing organisations, supported living providers
- Care providers
- Existing care technology providers
- Voluntary and community sector.
For each partner consider their degree of involvement and their relationship to the service. This could include:
- Joint commissioners
- Delivery partners
- A source of referrals (either funded by them or you)
- Users of the service for their own service needs.
Consider how to lay the foundations for effective partnership working by trying to see the world from their perspective:
- Their priorities: what are they focusing on at the moment and how might this agenda fit?
- How might this service realise benefits for them?
- Is this a good time to engage them?
- Are there governance arrangements to be considered? Are there existing governance arrangements that could support this work (eg existing system groups / programmes, S75 or BCF commitments)?
- Culture, skills and readiness
Influencing culture to create the conditions in which care technology can become an embedded part of social work practice, is widely used, requested and accepted by service users, families and carers is an area where organisations are continuing to learn and develop different approaches.
You may wish to consider:
- Training: A good training offer for staff in the service and for referrers is essential. Consider a range of media and content – a one hour session might be enough for some, others might need longer and on-going access to training to establish, maintain and grow skills. On-going training sessions are also a great way to troubleshoot service queries and gain insight directly from practitioners about their experience. Commissioners and service managers find it useful to be part of these sessions.
- Awareness: Do people know that the service exists, what it can offer, how it might help promote independence and achieve their priorities (staff, referrers, people in the community, other staff in your organisation)?
- Communications: Key to raising awareness, setting the right tone for messaging and an on-going activity. Are you using all the channels available and how do these match to the people you are trying to reach? How does your messaging and information about care technology penetrate and cross over into other corporate or adult social care communications activity? Is there relevant content on care technology, its benefits and your local service in your Information, Advice and Guidance offer for social care?
- Celebrating success and impact: Generate a resource of journeys and success stories through a range of media (video, case studies, on-line and off-line) and covering a range of uses, successes, circumstances and demographics
- Immersive experiences: Are there places where staff, service users, partners, influencers can see and experience the real-life impact of technology as a force for good in people’s lives?
- Peer-led approaches: Connect people to their peers who are passionate about care technology and want to share their learning
- Incentives: Consider whether there are appropriate incentives you can give to support take-up of your care technology offer, particularly in periods where you are trying to generate take-up
- Processes and systems: Make it easy to use the service, to generate a referral, minimise impact and effort on the referrer
- Communications and engagement
An effective communications and engagement programme around your care technology approch is a key component to achieving business and culture change and stimulating take-up and referrals. It is a constant and on-going task. Initially, you need to identify key audiences, channels, messages and objectives. Completing a stakeholder mapping exercise is a good place to start (see our Practice Resource). Key audiences will vary depending on your objectives and maturity of the service, but may include:
- Adult social care operations
- Adult social care commissioners
- Other internal teams or functions: children’s social care, corporate, IT
- Council leadership: executive leaders and elected members
- Key partners (see section 9) at a leadership, strategic and operational level
- Service users, carers, families
- Voluntary and community sector organisations
- The wider public
- Care provider market
- Care technology suppliers
Consider when and how you need to create your own content and channels and when you can use or add into existing communications mechanisms. Also consider a range of formats including videos, blogs, podcasts as well as written content.
Expect to need to refresh your approach to communications at least twice a year and more frequently if you are in a period of significant change eg new technology offer, procurement, mobilising a new service.
- Care technology pathways and service, digital readiness
Care technology pathways and service, digital readiness
Understanding what your current technology offer is and what you aspire for it to be is crucial – particularly in the context of the digital switchover and the capability and data opportunity provided by digital technology. Much of the expertise about technology sits with the market and service providers so this can be an area that may feel overwhelming for commissioners. There is no single source of good intelligence on the technology offers of the main national providers, let alone local providers and new market entrants. So there is some leg work ahead; draw on the expertise that may exist in your own organisation: any care technology champions, people with experience of care technology, your IT service.
In assessing current and future technology offers you may wish to consider:
- Digital compatibility: will the core offer be viable once analogue phone lines are switched over?
- Exploiting digital capability: good technology offers will not just be digitally compliant (analogue technology with digital adaptations) but designed for and capable of maximising digital capability (data flows and analytics, interoperability, Internet of Things)
- Data: consider your ambitions for using data to drive real time decision-making, prevent / anticipate crises in care, support effective care planning, drive commissioning and planning
- Range: what is the range of technology available? Is it flexible and evolving?
- Innovation: test out genuine approaches to and evidence of innovation by your service providers. Test out whether they are technology agnostic or whether they have long term commitments to suppliers and a standard core tech offer. When was this last updated?
- Innovation and data
Ensuring that there is continuous development and improvement in your service model, where and how it relates to other pathways, and that your technology offer remains up to date and relevant are all important aspects of moving towards a technology first approach for adult social care.
Some points to consider:
- Does your care technology service have an established innovation process for identifying emerging needs, scanning the market for emerging products and testing new technology with staff and service users against a range of criteria (eg reliability, robustness, user experience, cost, ease of installation etc.)
- Commissioners may need to find time to keep abreast of market developments – both in relation to technology and also in terms of the service models and offers of the key national players. Even if you are in a long-term contract or delivering an in-house service, there will be learning and intelligence that you can adopt
- Commissioners may need to keep close to operational priorities, service pressures and the experience of frontline social care staff to capture emerging needs. Spending time with frontline staff and visiting service users with technology installed is a great way of stimulating innovative ideas and seeing what does or doesn’t work in practice.
Data analytics including predictive analytics, AI, and developing decision support tools are all rich areas for innovation and will be an area for significant change in capability and application in the coming few years. The key to unlocking the potential of data over the longer term is to focus on your data infrastructure and strategy now. More advanced data analytics requires truly digital, interoperable hardware and software, and data storage capacity – ideally that can interface with other core systems like the case management system. Putting this in place will ensure that you can exploit the potential of data to add additional value over the longer term.
Consider carefully your approach to innovation in relation to your capacity and risk appetite. Do you want to be at the forefront of testing new technology? This has the benefit of early adoption and learning – but you should expect some of these experiments to fail and / or to find that the technology is not quite ready to be adopted at scale. Robotics and exoskeleton prototypes are a good example of this. If you want to be an early adopter but not at the cutting edge, then adjust your approach, resources and programme accordingly. Focus more on active scanning of the market and generating strong networks with innovators rather than putting your organisation and service forward as a test bed site.
This planning guide is not exhaustive but provides a series of prompts and questions, based upon the experiences of councils, to support local areas to develop their care technology approaches.
The final step of this resource is a Knowledge Hub Group which includes a number of practical care technology resources, tools and documentation that councils have shared to help others who are considering undertaking similar journeys. Details on how to access the practice resource can be found on the resource home page.